Gastrointestinal

The nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. Which statement should the nurse make to the client for consideration?

"Be sure to sleep with your head elevated in bed."

A sexually active 20-year-old client has been diagnosed with viral hepatitis. Which statement made by the client would indicate a need for further teaching?

"I can never drink alcohol again."

A client with possible hiatal hernia complains of frequent heartburn and regurgitation. The nurse should gather further information about the presence of which sign or symptom?

Difficulty swallowing

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion?

High-Fowler's position

A client has a diagnosis of asymptomatic diverticular disease. Which type of diet should the nurse anticipate being prescribed?

High-fiber diet

The client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which additional data from the client to support this diagnosis?

History of alcohol use, smoking, and weight loss

The client with peptic ulcer disease has been prescribed to take cimetidine. The nurse determines that which is the primary action of this medication?

Inhibits histamine action

The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should avoid which intervention?

Irrigating the nasogastric (NG) tube

The nurse is assigned to care for the client with a diagnosis of hepatic encephalopathy. Which prescribed medication should the nurse most anticipate administering?

Lactulose syrup

The nurse should include which instruction in a teaching plan for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

The nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse should anticipate a prescription to set the suction to which pressure?

Low and intermittent

A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid?

Lying recumbent after meals

The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, the nurse should focus on which priority intervention?

Maintaining a patent nasogastric (NG) tube

The nurse is caring for a client in the emergency department who has right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescription?

Milk of magnesia

The nurse will be providing postprocedure care to a client who has undergone esophagogastroduodenoscopy (EGD). Based on the procedure done, the nurse should plan to do which action first?

Monitor for return of the gag reflex.

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence?

Sweating and pallor

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which indicates this occurrence?

Sweating and pallor

A postoperative client has regained bowel sounds and is ready to start a clear liquid diet. The nurse is told that the primary health care provider has written a prescription to remove the nasogastric (NG) tube. The nurse assists in the procedure and should ask the client to do which during tube removal?

Take a breath and hold it until the tube is out.

A client diagnosed with hepatic encephalopathy is receiving lactulose. The nurse determines that the medication is effective if which finding is observed?

The client who was previously oriented to person only can now state name, year, and present location.

A primary health care provider is about to perform a paracentesis on a client diagnosed with abdominal ascites. The nurse should assist the client to assume which position?

Upright

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. When planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

Use diluted mouthwash and water to swab the mouth after brushing teeth.

A calcium supplement is prescribed for a client diagnosed with hypoparathyroidism in the management of hypocalcemia. The client arrives at the clinic for a follow-up visit and complains of chronic constipation, and the nurse reinforces instructions to the client about measures to alleviate the constipation. Which comment by the client would indicate a need for further teaching?

"I need to add 0.5 ounce of mineral oil to my daily diet."

Sucralfate 1 g four times daily has been prescribed for a client with a diagnosis of gastric ulcer. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 1 hour before my meals and at bedtime."

Metoclopramide four times daily has been prescribed for a client with a diagnosis of reflux esophagitis. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 30 minutes before meals and at bedtime."

Psyllium is prescribed for the client diagnosed with a cardiac disorder to facilitate defecation and prevent straining with bowel movements. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I should mix the medication with a full glass of water."

The client who is scheduled for an intravenous pyelogram has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which instruction should the nurse provide to the client?

"Take the medication on ice."

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid production."

The nurse reinforces medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy?

"The nizatidine will cause me to produce less stomach acid."

The nurse has reinforced instructions to the client who has been prescribed cholestyramine. Which statement by the client indicates a need for further teaching?

"This medication should only be taken with water."

Which statement by the spouse of a client with diagnosed end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding management of the client's pain?

"This opioid will cause very deep sleep, which is what my husband needs."

A client is admitted to an acute care facility with complications of celiac disease. Which question asked by the nurse initially should be most helpful in obtaining information for the nursing care plan?

"What is your understanding of celiac disease?"

The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to be prescribed?

-Administer antacids, as prescribed. -Encourage coughing and deep breathing. -Administer anticholinergics, as prescribed.

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures will most likely promote coping?

-Ask a member of the local ostomy club to visit with the client before discharge. -Ask the enterostomal nurse specialist to consult with the client before discharge. -Ask the client to begin doing one part of the ostomy care each day and increase tasks daily.

The nurse is reinforcing instructions to a client and his family about alcohol abuse and chronic cirrhosis. The nurse determines to include which essential elements in the discharge teaching guide?

-Avoid potentially hepatotoxic over-the-counter drugs. -Teach symptoms of complications and when to seek prompt medical attention. -Explain that cirrhosis of the liver is a chronic illness and the importance of continuous health care. -Avoid spicy and rough foods and activities that increase portal pressure such as straining at stool, coughing, sneezing and vomiting.

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to digest food. The nurse determines that which processes are involved in the complete digestive process?

-Chemical -Absorption -Mechanical -Active transport

The nurse who is reinforcing instructions to a client who has had a gastric resection should include which considerations? Select all that apply.

-Eat small frequent meals. -Take action to prevent dumping syndrome.

An acutely ill looking client arrives at the emergency department. The client complains of "the worst pain I ever felt in my belly. I can't get comfortable." The client is quiet but with each movement the client cries out in pain. The nurse suspects the client has peritonitis. Which data should the nurse collect to assist in validating this suspicion?

-Inspect the abdomen for rigidity. -Check for the presence of hiccups. -Inspect the client's mucous membranes.

A client has had a partial gastrectomy and the nurse is reinforcing discharge instructions. The nurse should reinforce instructions to the client about the need for which supplements?

-Iron supplements -Calcium supplements -Vitamin B12 injections

The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which considerations should the nurse include in the teaching session?

-It is advisable to stop smoking cigarettes. -Wait at least 1 hour after meals to perform chores. -Be sure to elevate the head of the bed during sleep.

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists?

-Nizatidine -Ranitidine -Famotidine -Cimetidine

The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia should the nurse reinforce to the client?

-Provide meticulous and frequent oral hygiene. -Use additional lightweight blankets as needed. -Check blood serum vitamin B12 levels every 1 to 2 years.

The nurse is caring for a client with a neurogenic bowel due to a lower motor neuron spinal cord injury below T12 resulting in flaccid functionality. Besides triggering or facilitating techniques for defecation, what are some of the strategies the nurse needs to address to reestablish defecation patterns?

-Suppository use -Manual disimpaction -Consistent toileting schedule

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse should schedule the medication so that each dose is taken at which time?

30 minutes before meals

A long-term care nurse is caring for an older client taking cimetidine. The nurse should observe this client frequently for which most common central nervous system (CNS) side effect of this medication?

Confusion

An older client has recently been taking cimetidine. The nurse should monitor the client for which most frequent central nervous system side effect of this medication?

Confusion

An adult client with hepatic encephalopathy has a serum ammonia level of 120 mcg/dL (72 mcmol/L) and receives treatment with lactulose syrup. The nurse determines that the client has the best response if the level changes to which after medication administration?

70 mcg/dL (42 mcmol/L)

The nurse has been reinforcing dietary teaching for a client diagnosed with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

A decrease in sour eructation

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. To aid the client in symptom management, the nurse should most appropriately suggest which diet during the acute phase?

A low-fiber diet

The nurse is caring for a client diagnosed with esophageal varices who is going to have a Sengstaken-Blakemore tube inserted. The nurse brings which priority item to the bedside so that it is available at all times?

A pair of scissors

The client with a diagnosis of gastric ulcer has a prescription for oral sucralfate four times daily. The nurse reinforces instructions to the client about which adverse or side effect that can occur while taking this medication?

Constipation

A client has undergone esophagogastroduodenoscopy (EGD). The nurse should place highest priority on which action as part of the client's care plan?

Checking for return of a gag reflex

A client with Crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client should take which action to monitor the effectiveness of treatment?

Checking the frequency and consistency of bowel movements

The nurse is reinforcing medication instructions to a client with peptic ulcer disease. Which represents correct information given by the nurse?

Cimetidine results in decreased secretion of stomach acid.

The nurse has a prescription to give 30 mL of an antacid through a nasogastric (NG) tube connected to wall suction. The nurse should do which best action to perform this procedure correctly?

Clamp the NG tube for 30 minutes following administration of the medication.

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?

Hepatitis A

The nurse notes that the medical record of a client diagnosed with cirrhosis states that the client has asterixis. To effectively verify this information the nurse should take which action?

Ask the client to extend the arms.

The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning, and all connections are snug. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse should conclude which is the problem and what action should be taken?

Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying.

A client is taking lansoprazole for the chronic management of Zollinger-Ellison syndrome. If prescribed, which medication would be appropriate for the client if needed for a headache?

Acetaminophen

The client asks the nurse about which product should be taken for a headache. The client is taking lansoprazole for long-term management of the diagnosis of Zollinger-Ellison syndrome. The nurse should determine that which medication is the most appropriate choice for this client?

Acetaminophen

The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription should the nurse most question?

Acetaminophen

The client arrives at an emergency department complaining of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the primary health care provider's prescriptions. Which prescription should the nurse most likely question if written on the primary health care provider's prescription form?

Administration of an opioid analgesic

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse should plan care, knowing that most likely, which problem will occur with this disorder?

Alteration in comfort related to abdominal pain

The nurse gathers data from a client admitted to the hospital with a diagnosis of gastroesophageal reflux disease (GERD) scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse should determine that the client may be most at risk for which complication?

Aspiration

A primary health care provider places a Miller-Abbott tube in a client who has a diagnosed bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Document the finding in the client's record.

A client is resuming a diet after partial gastrectomy. To minimize complications, the nurse should instruct the client to avoid which behavior?

Drinking liquids with meals

The nurse is collecting admission data on the client with a diagnosis of hepatitis. Which finding should the nurse recognize to be a direct result of this client's condition?

Drowsiness

The client arrives at the clinic complaining of dyspepsia and pain that occurs about 90 minutes after eating. The client also reports that the pain became worse this afternoon about 3 hours after eating a large bowl of spaghetti with tomato sauce. Laboratory tests reveal the presence of Helicobacter pylori (H. pylori). The nurse anticipates that the primary health care provider should prescribe which medications?

Esomeprazole Metronidazole Clarithromycin

The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse should most likely suspect that the client has which diagnosis?

Esophageal varices

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. Which is the best rationale for checking gastric residual volume before administering the tube feeding?

Evaluate absorption of the last feeding.

A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which sign/symptom should the nurse expect to observe based on this diagnosis?

Fatigue

The client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

Heartburn

The nurse is collecting data from a client who is taking pantoprazole. The nurse determines that the medication is most effective if the client states relief of which symptom?

Heartburn

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia should the nurse recognize?

Heartburn and regurgitation

A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is most likely a result of which condition that is part of the client's health history?

Hemigastrectomy

The nurse analyzes the results of laboratory studies performed on a client with diagnosed peptic ulcer disease (PUD). Which laboratory value would most indicate a complication associated with the disease?

Hemoglobin 10.2 g/dL

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. The nurse should determine that which data would further support this diagnosis?

History of chronic obstructive pulmonary disease with weight loss

The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history should the nurse determine is least likely associated with this disease?

History of the use of acetaminophen for pain and discomfort

A client with a diagnosis of acute pancreatitis is experiencing severe pain. After noting an absence of an analgesic prescription on the primary health care provider prescription sheet, the nurse should suggest contacting the primary health care provider to request a prescription for which medication?

Hydromorphone

Implemented treatment measures for a client with a diagnosis of bleeding esophageal varices have been unsuccessful. The primary health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse should prepare for insertion of this tube via which route?

Nasogastric

The client has an as needed prescription for ondansetron. For which condition should the nurse administer this medication?

Nausea and vomiting

A client has just taken a dose of trimethobenzamide. The nurse determines that the medication has been effective if the client reports which outcome?

Nausea and vomiting has been relieved.

The nurse is providing care for a client suspected of having appendicitis. Which priority intervention should the nurse anticipate will be prescribed for this client?

No oral intake of liquids or food

A client arrives at the emergency department complaining of severe abdominal pain and is placed on NPO status. During a quick assessment the nurse observes that the client has both Cullen's sign and Grey Turner's sign and pancreatitis is suspected. The nurse should assist to implement which action first?

Obtain vital signs and draw blood for laboratory analysis.

A client with a diagnosis of viral hepatitis has no appetite, and food makes the client nauseated. The nurse should conclude that which intervention is most appropriate?

Offer small, frequent meals.

A morbidly obese client, 3 days postoperative gastric bypass surgery, comes to the clinic complaining of pain. The nurse suspects that the client has an anastomotic leak requiring hospitalization. The nurse should determine that which findings best validate this suspicion?

Oliguria Restlessness Abdominal pain Unexplained tachycardia

The client has a prescription for sucralfate 1 g by mouth 4 times daily. The nurse should best schedule the administration of the medication at which time?

One hour before meals and at bedtime

The client with a gastric ulcer has a prescription for sucralfate 1 g by mouth four times daily. The nurse should schedule the medication to be administered at which times?

One hour before meals and at bedtime

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse should include which risk factor for colorectal cancer in the material?

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

The nurse has inserted a nasogastric (NG) tube in a client and is checking for the correct placement of an NG tube. Which is the most reliable data to ensure that the end of the tube is in the stomach?

Placement is verified on x-ray.

The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The test results indicate a pH of 5. The nurse should determine this indicates which information?

Placement of the NG tube is accurate.

The nurse is caring for a client diagnosed with a resolved intestinal obstruction who has a nasogastric tube in place. The primary health care provider has now prescribed the nasogastric tube to be discontinued. To best determine the client's readiness for discontinuation of the nasogastric tube, which measure should the nurse check?

Presence of bowel sounds in all four quadrants

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred?

Protruding and swollen

The nurse is caring for a client with a Sengstaken-Blakemore tube. To effectively prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to implement which action?

Provide frequent oral and nasal care on a regular basis.

The client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

Reduction of steatorrhea

The client is taking docusate sodium. The nurse should monitor which result to determine the client is having a therapeutic effect from this medication?

Regular bowel movements

The nurse should reinforce instructions to a client that has had a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information?

Regular monthly injections of vitamin B12 will prevent this complication.

The client who frequently uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. The nurse determines that this medication is having the intended therapeutic effect if which is noted?

Relief of epigastric pain

The client has begun prescribed lansoprazole. The nurse should primarily monitor for which intended effect of this medication?

Relief of nighttime heartburn

The nurse assigned to care for a client diagnosed with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care knowing that which client position will best assist in facilitating breathing?

Semi-Fowler's

The nurse is assisting with admitting a client to the hospital for the treatment of diagnosed dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications being taking. The client denies taking prescription medications but states he has been taking some herbs given to him by a cousin. The nurse should alert the registered nurse when the client states he has been taking which herb?

Senna

A postoperative client requests medication for flatulence (gas pains). Which medication from the PRN list should the nurse administer to this client?

Simethicone

A client has undergone subtotal gastrectomy, and the nurse is preparing the client for discharge. Which item should be included when reinforcing instructions to the client about ongoing self-management?

Smaller, more frequent meals should be eaten.

The primary health care provider has written a prescription for ranitidine, for a client with gastrointestinal reflux disease. The nurse is explaining how this medication works to treat this disease. Which explanation should the nurse give?

The medication suppresses acid secretion by blocking H2 receptors.

The client with diagnosed peptic ulcer disease has been prescribed misoprostol and sucralfate. The nurse reinforces teaching the client that these two medications will work primarily for which reason?

The medications protect the gastric mucosa.

The nurse is providing care for a client with a nasogastric tube. Which observation is most appropriate in determining that the tube is correctly placed?

The pH of the aspirate is 5.

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is most concerned with which bodily function?

The transfer of digested food molecules from the GI tract into the bloodstream

The nurse is reinforcing instructions to a client about insertion of a Sengstaken-Blakemore tube. Which statement by the client indicates a need for further teaching?

The tube will be inserted through my mouth to my stomach.

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should select which tube from the unit storage area?

Tube with a lumen and an air vent

The nurse is caring for a client with a diagnosis of pneumonia and a history of bleeding esophageal varices. Based on this information, the nurse should plan care knowing that which could most result in a potential complication?

Vigorous coughing

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency?

Vitamin B12

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment?

Vitamin B12 and folic acid studies

The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. During review of the postoperative prescriptions, which should the nurse clarify?

Irrigating the NG tube

Which infection control method should the nurse determine to be the priority to include in the plan of care to prevent hepatitis B in a client considered to be at high risk for exposure?

Hepatitis B vaccine

The nurse caring for a client diagnosed with acute pancreatitis and has a history of alcoholism is monitoring the client for complications. The nurse determines that which data collected is most likely indicative of paralytic ileus?

Inability to pass flatus

The client admitted to the hospital with a diagnosis of viral hepatitis is complaining of a loss of appetite. In order to provide adequate nutrition, which action should the nurse encourage the client to take?

Increase intake of fluids.

The nurse is assisting in planning stress management strategies for the client diagnosed with irritable bowel syndrome. Which suggestion is most appropriate for the nurse to give to the client?

Learn measures such as biofeedback or progressive relaxation.

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which?

Limit bleeding from the biopsy site

The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome?

Limit the fluids taken with meals.

A client is admitted to the hospital with a diagnosed bowel obstruction secondary to a recurrent diagnosed malignancy. The primary health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which action should the nurse determine is best?

Remain with the client and be silent.

The nurse notes that a client is taking lansoprazole. On data collection the nurse should ask the client which question to determine medication effectiveness?

"Are you experiencing any heartburn?"

The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement is most appropriate to be included in the teaching?

"Avoid lying down for an hour after eating."

A generally healthy 63-year-old man is seen in the primary health care provider's office for a routine examination. Which statement made by the client is most important for the nurse to follow up on?

"Everyone in my immediate family has died from gastrointestinal cancer."

A client is seen in the ambulatory care office for a routine examination. Which statement by the client should be most important for the nurse to follow up?

"I just lost a family member to gastrointestinal cancer."

The nurse has given the client diagnosed with hepatitis instructions about post discharge management during convalescence. The nurse determines a need for further teaching if the client makes which statement?

"I should resume a full activity level within 1 week."

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client should the nurse recognize as best supporting the diagnosis of gastric ulcer?

"My pain comes shortly after I eat, maybe a half hour or so later."

The nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. Which settings should the nurse anticipate to be prescribed by the primary health care provider?

-Low -Intermittent

The client in an emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions?

-Milk of magnesia -Heat pad to the abdomen

A client diagnosed peptic ulcer disease and scheduled for a pyloroplasty asks the nurse about the procedure. The nurse should base the response on which information?

A pyloroplasty involves an incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should correctly select which tube from the unit storage area?

A tube with a larger lumen and an air vent

A client with viral hepatitis states to the nurse, "I am so yellow." The nurse should best respond by taking which action?

Assist the client in expressing feelings.

A primary health care provider has written a prescription for ranitidine 300 mg once daily on the client's discharge medication list. The nurse determines to instruct the client to take the medication at which time?

At bedtime

The nurse is getting a client who underwent umbilical hernia repair ready for discharge. The nurse explains to the client that it is important to continue to do which action after discharge?

Avoid coughing.

The client diagnosed with portosystemic encephalopathy is receiving oral lactulose daily. The nurse should check which to determine medication effectiveness?

Blood ammonia level

The nurse is administering a dose of prochlorperazine to the client for nausea and vomiting. The nurse should instruct the client to report which frequent side effect of this medication?

Blurred vision

A client receiving a high cleansing enema complains of pain and cramping. Which corrective action is most appropriate for the nurse to take?

Clamp the tubing for 30 seconds and restart the flow at a slower rate.

A client is receiving bolus feedings via a nasogastric tube. The nurse plans to place the client's head of the bed (HOB) in which optimal position once the feeding is completed?

Elevated 30 to 45 degrees with the client in the right lateral position for 60 minutes

The nurse is preparing to reinforce instructions to the client who has been given a prescription for diphenoxylate with atropine. Which instructions should the nurse include?

Do not exceed the recommended dose because it can be habit forming.

The nurse should document that a client diagnosed with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action?

Eating low-fat or nonfat foods

The nurse is instructing a client who had a herniorrhaphy about how to reduce postoperative swelling following the procedure. Which should the nurse suggest to the client to prevent swelling?

Elevate the scrotum.

The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings?

Fowler's

A licensed practical nurse (LPN) is assisting in the insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by performing which measurement?

From the tip of the client's nose to the earlobe and then down to the xiphoid process

The nurse is interpreting the laboratory results of a client who has a history of diagnosed chronic ulcerative colitis. The nurse should determine that which result indicates a complication of ulcerative colitis?

Hemoglobin 10.2 g/dL

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which statement made by the client indicates a need for further teaching?

I will eat a bland diet only.

The nurse is reviewing the medication record of a client with a diagnosis of acute gastritis. Which medication noted on the client's record should the nurse most likely question?

Ibuprofen

The nurse is working with a client diagnosed with anorexia nervosa. As the nurse plans care, which should be focused on as the primary problem?

Impaired nutritional status

The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

A nurse organizing care for a client diagnosed with hepatitis plans to meet the client's safety needs by performing which action?

Monitoring prothrombin and partial thromboplastin values

The nurse is collecting data on a client admitted to the hospital with a diagnosis of hepatitis. The nurse should determine which data indicates the client may have liver damage?

Pruritus

The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be immediately reported?

Pulsation between the umbilicus and pubis

A client diagnosis of a peptic ulcer scheduled for a vagotomy asks the nurse about the purpose of this procedure. The nurse should explain to the client that a vagotomy primarily serves which purpose?

Reduces the stimulation of acid secretions

A client that is postgastrectomy being discharged from the hospital tells the nurse, "I hope my stomach problems are over. I need to get back to work right away. I've missed a lot of work, and I may lose my job." Based on the client's statement, the nurse should determine that at this time, it is most appropriate to discuss which topic?

Reducing stressors in life

The nurse has assisted the primary health care provider with a liver biopsy, which was done at the bedside. Upon completion of the procedure, the nurse should assist the client into which position?

Right side-lying with a small pillow or towel under the puncture site

The nurse is performing colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. The nurse should take which appropriate action?

Stop the irrigation temporarily.

The nurse is reviewing the primary health care provider's (PHCP'S) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart?

Supine and flat client positioning

A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN should assist the client into which most appropriate position?

Supine with the head raised slightly and the knees slightly flexed

The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse should include which instruction to the client?

Take actions to prevent dumping syndrome.

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse should take which immediate action?

Take the client's vital signs.

The client diagnosed with peptic ulcer disease has a new prescription for propantheline. Which client teaching instructions should the nurse most reinforce?

Take the medication 30 minutes before meals.

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which data finding best indicates adequate location of the tube?

The aspirate from the tube has a pH of 7.45.

The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet?

Turkey and lettuce sandwich

A client diagnosed with chronic gastritis has been told that there is too little intrinsic factor being produced. The nurse should explain to the client that which therapy will be prescribed to treat the problem?

Vitamin B12 injections

The client uses the alternative therapy of cascara sagrada, known as Californian buckthorn, for ongoing management of chronic constipation. The nurse should monitor the client's laboratory results for which electrolyte imbalance specifically related to long-term use of this medication?

Hypokalemia

The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse should determine that which data noted in the record indicate poor absorption of dietary fats?

Steatorrhea

The client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication?

An episode of diarrhea

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action should the nurse encourage the client to do?

Eat anything as long as it does not aggravate or cause pain.

A client admitted to the hospital diagnosed with severe jaundice is having diagnostic testing. Because the client has no complaints of fatigue, the client is encouraged to ambulate in the hall to maintain muscle strength. The client paces around the room but will not enter the hall. The nurse should determine which concern is most likely the reason for the client's reluctance to walk in the hall?

Feeling self-conscious about appearance

Atropine sulfate is prescribed for the client diagnosed with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which finding, if noted on the client's record, most indicates the need to contact the primary health care provider before administering the medication?

Narrow-angle glaucoma

A client that is postgastrectomy is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse should plan to monitor which data?

Postprandial blood glucose readings

A primary health care provider asks the licensed practical nurse (LPN) to reinforce preprocedure instructions to a client who will undergo a barium swallow (esophagography) in a few days. The LPN should include which instruction in this discussion?

Remove all metal and jewelry before the test.

The client has a prescription for metoclopramide four times a day. The nurse determines that which is the most appropriate time to schedule this medication?

Thirty minutes before meals and at bedtime

The client with recurrent constipation has begun using psyllium. The nurse should instruct the client that this medication should be taken in which manner?

With a full glass of liquid, followed by a second glass of liquid

The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse should monitor for which priority sign/symptom?

Respiratory distress

A client has been diagnosed with acute gastroenteritis. Which diet should the nurse anticipate to be prescribed for the client?

Low fiber

The client diagnosed with acute pancreatitis is experiencing severe pain from the disorder. The nurse should instruct the client to avoid which position that could aggravate the pain?

Lying flat

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record?

Diarrhea

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse should monitor the client closely for which priority esophageal complication?

Hemorrhage

The client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

Vomiting following cancer chemotherapy

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which considerations concerning ongoing self-management should the nurse reinforce to the client? Select all that apply.

-Eat smaller and more frequent meals. -Drink fluids between meals not with them.

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. Which interventions should be included in the procedure?

-Explain the procedure to the client. -Ask the client to take a deep breath and hold. -Pull the tube out in one continuous steady motion. -Remove the device or tape securing the tube from the nose.